What is hepatitis A?

Hepatitis A is a viral infection of the liver. The liver is one of the largest organs and a very important part of your body. Some of the functions of the liver include:

• It helps your body get rid of some medicines and harmful substances.
• It makes bile, which helps your body digest fats.
• It stores sugar, which your body uses for energy.
• It makes many proteins, which are the building blocks for all cells in the body.

When you have hepatitis, the liver is irritated (inflamed). It may be swollen and tender.

What is the cause?

Hepatitis A is caused by the hepatitis A virus (HAV). The virus is spread by contact with infected bowel movements. Someone who is infected may pass the infection to others by not washing his or her hands, especially after using the bathroom. You might also get the virus from:

• Eating food handled by an infected person
• Drinking untreated water or eating food that was grown, washed, or prepared in untreated water
• Having anal-oral sex with someone who is infected

You have a higher risk for infection if:

• You travel to a country where hepatitis A is common.
• You live or work in an area that has outbreaks of hepatitis A.
• You use illegal drugs.
• You have HIV/AIDS.
• You have unprotected sex with an infected person.
• You live or work in a nursing home or rehabilitation center.
• You work in the healthcare, food, or sewage industry.

Hepatitis A is usually contagious for 2 to 3 weeks before symptoms appear and for 2 to 3 weeks afterward. During this time, others can be infected by touching anything contaminated with bowel movements of the infected person. The disease can be spread by people who do not have any symptoms and may not know they carry the virus.

What are the symptoms?

Symptoms usually appear 2 to 6 weeks after you are infected with the virus. Sometimes hepatitis A is so mild that there are no symptoms.

If you have symptoms, the illness usually starts with:

• Loss of appetite
• Fever
• General aching
• Feeling tired

After several days you may also have these symptoms:

• Nausea and vomiting
• Dark urine
• Yellowish skin and eyes (jaundice)
• Pain just below the ribs on your right side, especially if you press there
• Bowel movements that are whitish or light yellow and may be looser than normal

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Your provider will ask about any recent travel. You will have blood tests.

How is it treated?

The main treatment is rest. Recovery from hepatitis A usually takes 4 to 8 weeks. You may feel like you don’t have much energy for months. The disease rarely has lasting effects. It usually does not cause permanent liver damage. Your healthcare provider will recommend that you avoid alcohol for at least 6 months. When you have hepatitis, alcohol speeds up damage to your liver and makes it harder for your body to fight the infection.

Usually you do not need to stay at the hospital for treatment. If you get dehydrated from nausea and vomiting, you may need to go to the hospital to get IV fluids.

Because the infection is caused by a virus, antibiotics will not help.

How can I take care of myself?

• Follow your provider’s instructions for taking medicine for your symptoms. You need to avoid taking medicines that can damage the liver–for example, acetaminophen. Ask your provider which medicines you can safely take for symptoms such as nausea.
• Follow your provider’s advice for how much rest you need. It’s best to avoid a lot of physical exertion until your provider says it’s OK.
• Eat small, high-protein, high-calorie meals, even when you feel nauseated. Sipping soft drinks or juices and sucking on hard candy may help you feel less nauseated.
• Don’t drink alcohol until your healthcare provider says it is safe.
• Ask your provider:
  • How and when you will hear your test results
  • How long it will take to recover
  • If there are activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them
• Make sure you know when you should come back for a checkup.

How can I help prevent hepatitis A?

You can get shots that prevent hepatitis A. Two shots are given 6 to 18 months apart. Healthcare providers usually recommend that you get the shots if you have a higher risk for hepatitis A or if you have long-term liver disease or a blood clotting disorder.

If you are planning travel to an area where hepatitis A is common, you should have the first shot at least 1 month before you start your travels. Check with your healthcare provider about when you should have a second shot. Two shots of this vaccine can protect against hepatitis A for many years.

Hepatitis A vaccine is available as a combination vaccine with hepatitis B. The shots help prevent more damage to your liver from other types of hepatitis. Ask your healthcare provider if this is right for you.

If you have not had the hepatitis shots and you have been exposed to hepatitis A, you may be given a shot of immune globulin. Immune globulin may not always prevent hepatitis A, but it may make it milder. The protection starts almost right away but lasts for just 2 to 4 months.

If you have an active hepatitis A infection, always wash your hands thoroughly after using the restroom. This will help prevent spread of the disease to others.

If someone in your household has hepatitis:

• Ask your healthcare provider if you need to get a hepatitis or immune globulin shot.
• Wear disposable gloves if you must have contact with the sick person’s bowel movements, body fluids, clothing, towels, or bed linens.
• Wash the infected person’s clothing and bed linens separately from other laundry. Use very hot water and a strong detergent.
• Clean toilets and other bathroom surfaces with a disinfectant. Wear gloves when you clean. If possible, it’s safest to have the infected person use a different bathroom from everyone else in the household for about 1 month after they first get sick.

You can get more information from:

• American Liver Foundation
  800-465-4837
  http://www.liverfoundation.org